For most people, the culmination of a prosperous life is a "good death," although what that means is associated with certain fears. Researchers at the University of California San Diego School of Medicine looked at peer-reviewed published English-language reports of qualitative and quantitative definitions of “good death” and ultimately identified 11 major factors associated with a successful life path.
The study was published in the April issue of the American Journal of Geriatric Psychiatry.
The team, led by Dilip Este, director of the Sam and Rosa Steins Aging Research Institute at the University of California, focused on three groups of participants: patients, family members (before or during bereavement), and healthcare professionals.
“This is the first time data from all parties involved has been pulled together,” said Este, who is also the associate dean of the Department of Healthy Aging and Aged Care at the San Diego School of Medicine. “Death is obviously a controversial topic. People don't like to talk about it, but we have to. It is very important to speak honestly and openly about what kind of death each of us would prefer."
The literature search was carried out on the basis of 32 special studies. 11 main issues related to a “good” death were identified: preferences in the dying process, painless state, religiosity / spirituality, emotional state, completion of life, preferences in care, tributes, family, quality of life, relationship with the doctor others.
The three most important topics across all groups included preference for dying, painlessness, and emotional well-being. For other topics, different stakeholders gave them different attention. For example, patients are more likely to view the issue of religiosity / spirituality as important than family members who believe that respect and completion of life are more important for a successful death. Health care professionals tended to express opinions as a cross between the opinions of patients and family members.
“Clinically, we often see a difference between what patients, family members, and healthcare workers place the most value on in a person on the brink of death,” says Emily Meyer, a psychologist at the San Diego School of Medicine cancer center. “Ultimately, existential and other psychosocial problems may prevail among patients, and this serves as a reminder that we must explore all aspects of the care they need at death's door.”
The most important thing in this, says Este, is to "ask patients."
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“As a rule, patients know what they need, and when they talk to them about it, it makes them feel better. It gives them a sense of control. I hope these findings will contribute to a broader discussion across the spectrum.”
Sergey Lukavsky